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Pine Creek Counseling, LLC

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Company Details

Name: Pine Creek Counseling, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 02 Dec 2022 (3 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 5006037
Place of Formation: IDAHO
File Number: 852160
ZIP code: 83455
County: Teton County
Principal Address: 1310 BUCKSKIN LOOP VICTOR, ID 83455
Mailing Address: 1310 BUCKSKIN LOOP VICTOR, ID 83455-1327

Agent

Name Role Address
Katelyn Webb Agent 1310 BUCKSKIN LOOP, VICTOR, ID 83455

Manager

Name Role Address Appointed On
Katelyn Webb Manager 1310 BUCKSKIN LOOP, VICTOR, ID 83455 2024-01-05

National Provider Identifier

NPI Number:
1366249906
Certification Date:
2025-03-01

Authorized Person:

Name:
KATELYN WEBB
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006006764 2024-12-04
Annual Report 0005543232 2024-01-05
Initial Filing 0005006037 2022-12-02

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Date of last update: 26 Mar 2025

Sources: Idaho Secretary of State